If the Covid-19 vaccine is ready for roll-out in early 2021, it will give rise to a huge demand for syringes and glass vials. And while manufacturers say they are ramping up capacities, there may be a supply crunch in the second half of next year, as international supply commitments, too, pick up.
India has an annual capacity to make about 1.08 billion 0.5 ml AD (auto-disable, or those that are automatically disabled after a single use) syringes. The three key manufacturers, Hindustan Syringes and Medical Device (720 million), ISCON Surgicals (180 million), and Becton Dickinson (180 million), are planning to increase this to 1.42 billion by mid-2021. Of this, around 50 per cent are planned for exports. Therefore, about 860 million pieces of syringes would be available for India.
India plans to conduct the vaccination drive in phases. In the first phase, 30 million health care and essential services workers will be vaccinated. By July 2021, the plan is to vaccinate about 250 million people. Each person will need two vaccine shots, or two syringes. In other words, by July 2021, the government would need 500 million syringes only for Covid-19 shots. Add to this the syringes needed for the routine universal immunisation drive programmes.
Typically, the government procures 300 million syringes every year to vaccinate around 24 million children. This year, the government has so far picked up only 150-200 million syringes. According to sources, HMD and ISCON have an inventory of 70 million and 17 million syringes, respectively.
An industry source holds that the government has about 150 million syringes lying with it. Another 100 million is lying with manufacturers. These 250 million pieces could take care of the first phase of the Covid-19 vaccination drive aimed at covering 120 million Indians. This is probably why the government has not yet placed additional orders for syringes or has even indicated what could be the likely demand.
But manufacturers are busy doing the math. They expect the government to need at least 500 million syringes by July, in addition to the 300 million that it orders for the annual immunisation drive. And post July, there will be an additional demand for Covid-19 vaccination syringes. Hence, the industry expects a significant shortage, given that they will also have global commitments.
“We are now manufacturing what we project to be the demand from the health ministry till March. This will be completed by December this year and we will stockpile it at risk. In January, if the government suddenly needs syringes for a Covid19 vaccine, we will have the spare capacity to make them quickly. Else, we will give our stockpiled production to UNICEF,” explained Rajiv Nath, managing director, HMD.
HMD is expanding its syringe making capacity in phases. It aims to raise it to 800 million (from the current 720 million) by the year end, and to one billion pieces by June next year. “We can take it up to 1.5 billion if we have proper contracts,” Nath said.
HMD is slated to supply 140 million syringes to vaccine alliance body COVAX, of which it has shipped 56 million pieces already, and is ready to dispatch another 28 million. Nath pointed out that while vaccines ship by air, syringes are transported by sea freight. If a mass immunisation drive is planned somewhere, syringes need to be shipped at least three months ahead of the date.
Pavan Mocherla, managing director, Becton Dickinson – India and South Asia, said, “Several countries and institutions such as the UNICEF and Gavi have already placed orders with us for the delivery of syringes for Covid vaccination.” He added that the Indian government had not given any indication of its requirement as yet.
The second aspect of planning for raising syringe manufacturing capacity is based on the extent of public and private vaccination, because the government uses AD syringes, and the private market mostly uses disposable syringes.
“Let’s assume that 70 per cent of the 1.3 billion people will be vaccinated. That means 900 million people need to be given a jab, which requires 1.8 billion syringes. If it is done entirely by the government, then all would be AD syringes, but if it is a 60:40 government-private divide, then almost 800 million syringes will be disposable. We need clarity on this soon,” Nath said.
As for the vials in which vaccines are stored, major players are Piramal Glass, Schott Kaisha, Borosil and Gerresheimer India. Gerresheimer India has indicated that it will triple its capacity for tubular glass vials by 2020 end, apart from doubling the capacity for moulded vials by the end of 2021. Moulded vials are more affordable and can also be used for different dosages.
Vijay Shah, vice-chairman of Piramal Glass, which enjoys over 50 per cent market share in India for glass vials, said that the company had already seen a demand spike from vaccine manufacturers and other pharma players. Piramal has initiated talks with vaccine makers like Cadila Healthcare and Bharat Biotech and has also secured export orders from China, Mexico and Brazil. According to Shah, despite the panic, there would be no shortage of glass vials.
However, vaccine makers believe there could be a severe supply crunch. Mahima Datla, MD, Biological E, told Business Standard, “The final product containers could be an issue. For some vaccines, if you don’t have the right preservatives, you may be able to fill only two doses in a vial, and this increases the cold chain requirements. If you can fill 20 doses in a vial then we need less vials. There are very few tubing manufacturers in the world. Vaccine makers can forward buy from vial suppliers and enter into forward contracts,” she said.
Meanwhile, industry sources indicated that vaccine makers like the Serum Institute of India were already trying to innovate on packaging — from packing 10-doses in one vial, they were looking to pack 25 doses in one vial, thus reducing the requirement for vials.
The government has formed a sub-committee on supply chain to plan for the smooth rollout of the vaccine if and when it is available for distribution. Representatives from the department of pharmaceuticals, the national pharma pricing regulator, and the drug regulator are part of the committee and they are in touch with industry to plan and manage the supply chain. – Business Standard